While China tries to eradicate COVID-19 infections as soon as they emerge, the US has a much more laissez-faire approach to learning to live with the virus, even if it means a thousand deaths a day.
MARY LOUISE KELLY, Host:
In China, a single COVID case recently closed Shanghai Disneyland. Health workers in hazmat suits tested park guests for the virus as part of a contact tracing effort that ensnared tens of thousands of people. The country as a whole reports on average well below 100 COVID cases per day.
AILSA CHANG, HOST:
Compare that to this country, where we record more than 70,000 new COVID cases per day. And most restrictions have been lifted. The US and China present two divergent views on where the pandemic is headed and what we plan to do about it, as the coronavirus, like the flu, will become a regular part of life for years to come.
KELLY: So what’s the game plan from here? And what can we learn from the way countries like China approach this? Well, to talk about that are NPR health reporter Pien Huang and NPR China correspondent John Ruwitch.
Hi, you two.
PIEN HUANG, BYLINE: Hey, Mary Louise.
JOHN RUWITCH, BYLINE: Good afternoon.
KELLY: John, you start with what I understand China calls a zero-tolerance policy. What does that actually mean on the ground?
RUWITCH: Well, this is the approach China has been using since the earliest days of the pandemic when Wuhan was shut down, if you remember, about two years ago. So basically China’s borders are closed with very strict quarantines for people coming in. And where there have been flare-ups, they have imposed strict lockdowns and are doing massive testing. So what will happen is that the numbers are disproportionate. You have a suspicious case or two, or a few, and the consequences – the discomfort – will be felt quite widely.
KELLY: And allow me to be a little skeptical about the numbers for a moment.
KELLY: Less than a hundred cases a day in a country the size of China. Do we think there is underreporting?
RUWITCH: There may be underreporting. However, I have spoken with two public health experts, who are closely following China, and they are convinced that the Chinese statistics are broadly correct. I mean, as someone told me, the Chinese government isn’t really giving the virus a chance to spread on a large scale.
KELLY: Like, I think, was demonstrated at Disneyland in Shanghai. Tell us more about what happened.
RUWITCH: Exactly. Yes, someone who visited the park was identified as a close contact, and soon after tested positive. This is after they left Disneyland. And the government closed the park – 33,863 visitors and staff were locked up. They were all tested and released the next day after…
RUWITCH: …There were negative results. Overall, however, this approach has yielded impressive results for China. They have reported more than 200,000 cases and about 5,000 deaths. There have been almost no deaths since that outbreak was brought under control in Wuhan.
KELLY: Pien, step in here and contrast this with, clearly, a very different approach unfolding here in the US. We are not at all like zero tolerance.
HUANG: Absolutely. Yes. I mean, you know, compare China’s less than 200,000 cases to what’s happening here in the US where we’ve had over 46 million cases. And even now, COVID community transmission is substantial or high in every US state. But bars and restaurants are open. People are going back to work and school. And the US goal is now really focused on getting a large part of the population vaccinated. At a Senate committee hearing last week, Dr. Anthony Fauci a vision for where this is all leading.
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ANTHONY FAUCI: So as we get more people vaccinated worldwide, hopefully in a reasonable amount of time, we’ll get to a point where it can be up and down in the background every now and then, but it’s not going to dominate us the way things are going well right now.
KELLY: Dr. Fauci testified there last week. And I know – when we had him on the show last week – I interviewed him on Friday and asked, is there a song he’s watching most closely to gauge where we are in all of this? Does it reduce the number of cases? Does it reduce the number of deaths? Does it get more gun shots? He said all of the above, you can’t do it in isolation. Is that correct, Pien, with what others tell you while you are reporting?
HUANG: It’s a little bit of everything, but the emphasis on each of these things changes depending on the phase of the pandemic we’re in. So health officials say they’ve put a lot of thought into what an endemic phase looks like, and they say they’re modeling it after flu. So in terms of what that means, that means less focus on case numbers, more focus on serious illness, hospital capacity and deaths. Some health experts say we should also monitor long COVID cases, especially the severe ones. But we are not yet in that endemic phase. There are more than 70,000 cases a day in the US, and health officials have said if that number drops below 10,000 a day, the virus will be under control. According to those statistics, China has the virus under control. But US officials intend to maintain that low number of cases with people attending school, working, enjoying travel and leisure, so the US is a long way from that.
KELLY: John, what’s the downside of the approach China has taken? — because less than a hundred cases a day sounds pretty good.
RUWITCH: Yes. Look, initially this worked for China. Economically, China was able to back out faster than any other country. You will recall that it was the only major economy to grow last year. Politically, the Chinese Communist Party has acted on it and claims its approach is working. However, it is now more complicated and there are declining yields with the spread of the delta variant in China. There are more flare-ups and more lockdowns, and especially since the summer it has become more widespread. And it is clearly taking its toll on domestic consumption, which is an important part of the economy. You know, when things close, like movie theaters, malls, and when travel is restricted, that has an effect. The government is in a bit of a dilemma. I mean, there are signs of lockdown fatigue in some parts of the country. But for those who aren’t locked up, you know, they expect zero cases by and large.
KELLY: So is the Chinese approach sustainable?
RUWITCH: Other countries that have taken this approach, such as Australia and New Zealand, Singapore, are moving away, and China is pretty much alone there. For now, though, the leadership seems to think it’s all worth it. The price could be higher if they tacked, you know. Beijing will host the Winter Olympics in three months, and an outbreak before or during the Olympics would be a disaster from their perspective. When winter is over, China is entering this politically sensitive time ahead of a leadership reshuffle. There are also big question marks scientifically. I spoke to Xi Chen about this. He is a public health expert at Yale University.
XI CHEN: Unfortunately, China has no data to make decisions. They really need the virus transmission data and vaccine efficacy to reopen. Otherwise, policy making is very difficult.
RUWITCH: His point here is that China has done so well in eradicating the virus that they have no data on how fast it is spreading in the country. They have no data on how well Chinese vaccines work against it in the real world. One last point: China’s health care system is understaffed and ill-prepared for a spike that would be inevitable if they relaxed their policies. And China’s leaders know this, and they are concerned that hospitals will be overloaded.
KELLY: Pien, I’ll give you the last word here. Is this just that there is a very different risk tolerance in China and the US, that Americans are willing to tolerate a certain level of illness, even a certain level of death from COVID if we are able to deal with something akin to our old normal life?
HUANG: Well, there is certainly a difference in risk, but also in terms of what people are willing to tolerate between our societies. You know, here in the US, health officials have been trying to strike a balance between public health and individual rights, something that people can interpret very differently. Here’s Dr. Jose Romero, secretary of health for Arkansas.
JOSE ROMERO: First of all, we could never do what was done in China, right? People wouldn’t tolerate it. And so we have to work within the freedoms of our system.
KELLY: But does it have to be either-or, Pien? Is there some sort of middle ground between the Chinese approach and the American approach?
HUANG: Well, Romero says that the US is actually somewhere between China’s approach and that of the UK, which has lifted almost all mandatory restrictions in favor of vaccines and people’s common sense. Remember: the pandemic threat will not end until the virus is under control everywhere. It started in a Chinese city and now affects every corner of the world.
KELLY: NPR health reporter Pien Huang and China correspondent John Ruwitch talk about two very different approaches to where the pandemic is headed now.
Thanks to you both.
HUANG: Thanks for having us.
RUWITCH: Thank you, Mary Louise.
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